HW 40 - Insights from Book - Part 3

I seem to have found myself at a cocktail party, when in walks Marsden Wagner, the author of the book, Born In the USA, which coincidentally, I have just finished reading.

Elizabeth:

Hey there Dr. Wagner!

Marsden Wagner: 

Pardon me, but, do I know you?

Elizabeth:

No, but I just finished reading your book, Born in the USA, which I really enjoyed. Your main idea that the current system we use in America is more harmful than healthy made me think differently about the current status of our maternity system.

Wagner, surprised to be talking to someone who actually rephrased the main idea of the text instead of sharing their own birth story, replies curiously. 

 Wagner:

Really? Which parts were most effective or important for you?

Elizabeth:

Well, in the last third of the book you focused on methods to change the flaws in the maternity system, which further developed your thesis. You suggested many different solutions, but the three most realistic ones, in my opinion, were from pages 220, 240, and 242  where you mention educating the public, improving public health, and following the money.

At this point, Marsden has realized that he's having a unique conversation with a serious reader of his book.

Marsden:

But what could I have done to make this book so that it would more effectively fulfill its mission and to be all around better?

Elizabeth:

Well, your text sought to provide a system analysis from the perspective of what one would consider an expert in the subject, so the book-reading-public could better understand the maternity system in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be to rethink the solutions you provide in the book. While I do believe that you have created valid arguments as to why policies and standards need to change, I do think that some of your solutions contradict one another. 

Marsden:

How so?

Elizabeth:

Well, one of the solutions you mention is to create coalitions, but at the same time you mention that governmental standards need to be reformed. But they don't completely conflict one another.  I don't want you to feel like I'm criticizing, I genuinely appreciate the immense amount of labor you dedicated to this important issue. But most particularly for making me think more about the immense influence that money and politics have on the United States maternity system and the general safety- both physically and mentally- of mothers, children, midwives, and families has been heavily disregarded. In fact, as a result of reading your book, I'm likely to have a home birth of my own in the future, unless the system changes in favor of a more natural birth. 

Marsden:

Thanks! Talking to you gives me hope about our future as a society!

HW 39 - Insights from Book - Part 2

 Wagner, Marsden. Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First. Univ of California Pr, 2008. Print. 

While comparing The Business of Being Born and Born in the USA, I've found that the main difference between the two is the audience for which each medium is aimed. The Business of Being Born focuses heavily on the emotional aspect of pregnancy/birth whereas Born in the USA incorporates the emotional and business sides of the maternity system. The chapters I've most recently read were about midwives and legalities. This part of the book relates heavily to The Business of Being Born (TBBB) because they both fixate on midwives. The difference is that Born in the USA (BUSA) examines and gives examples of legal cases in which "the good guys" have been direct targets of the maternity care system. I personally enjoy watching TBBB more than reading BUSA because it's much more engaging. BUSA does have some really good information and touching stories to share, but I feel that the setup which they are given creates a strong unintrest for the reader. Example, on page 143 of the book, the reader is given a boatload of percentages and numbers and basically have to create an image in their head of how the data would be set up. I personally had to read over it 5 times to get the general idea of how the numbers would look next to one another, but I can hardly imagine that every single reader re-reads things they understand. In fact, normally I'd probably skim it and tell myself that the context would help me understand it. But the context didn't. And anything that came afterwords didn't really help to explain what the data meant. (Would put in quote but it takes up a full 1/2 page).

The second part of BUSA forces the idea that midwives are generally (not always, there was some counter-evidence) better birth-helpers due to emotional as well as health factors. I feel as though giving birth with a midwife would in fact be the best experience for giving birth. It seems much more emotional and not as sterile as hospital birth. Through my reading I've created a sort of mindset that doctors don't care about the patient, they simply care about the money, and how to make it fast.

HW 38 - Insights from book - part 1

Born In The USA

Marsden Wagner, M.D., M.S.

In Born In The USA, there are 9 chapters, each providing a new argument/reasoning behind the thesis. The first four chapters focus on the nightmarish aspects of maternity. I haven't read past chapter four, but from looking at the table of contents, it will most likely be another nightmarish chapter, but will also provide alternatives to the current system.

The major question the book is trying to answer is somewhere along the lines of "what is bad in the current US maternity system, and what can be done to change these things". So far, from what I've learned, I think a lot of what is wrong with the system are the doctors. They are so scared of a malpractice lawsuit that cesarean section is becoming the "easy way out". 

Chapter one is on the current state of maternity care, the second provides insight into the close-knit world of doctors, and the third is about surgery being incorporated into birth. The general thesis is most likely that the current maternity system is so heavily based around the hospital experience that people are losing sight into the process of giving birth.

One aspect of birth that deserves public recognition is that obstetrician aren't present during labor, but they rush in at the last moment, to help bring the baby out. They'll make money no matter what, but it shows that there is an impersonal connection between a pregnant woman and her doctor. 

Something else that disgusted me was that when a doctor is faced with a malpractice lawsuit, most doctors will not testify against them because it could mean losing referrals from other doctors, therefore losing money. 

Another thing that really riles up the author of this book, Marsden Wagner, is Cytotec. Cytotec is a drug that can be used to induce labor, but it's use has resulted in death. 

One idea that is heavily pounded into the readers' heads is that surgeons are not scientists. Surgeons are trained to cut, remove, replace, etc. and can be more useful in situations not involving birth, which generally hasn't involved scalpels, scissors, and forceps.

The evidence in this book pulls from many sources; the writer's personal experience with medical training and practice, charts, statistics and real-life stories/examples. The entire book is basically composed using mainly evidence, mainly through stories and a a few tables thrown in here and there. I think that while some of the points that are being made in this book are interesting, a lot of it is repeated in different forms of evidence... not that it's bad to back up arguments with evidence, but sometimes the reader can get sick of hearing the same idea said over and over again but in different ways. 
A lot of the numerical evidence seems reliable because it is cited either in text or in the index. I've flipped through the index, which is actually a little helpful in telling the reader what is generally found in each source. 

HW 37 Comments on Birth & Pregnancy Stories

Comments I made:
Lucas:

I really enjoyed reading this post. Overall you did a great job. But I think you did best at keeping the stories informative yet short (a problem I faced in writing my assignment).

One of the only things I could think of changing would be the placement of this section, "Women who have miscarriages sometimes blame themselves for the event, wondering if every little event was the one that caused it. It can be psychologically devastating, and is hard to deal with without therapy. This link was somewhat informative on the topic". The reason for this is because that paragraph was a narrative, not research or response. I would have started off the next paragraph with a bit of rephrasing like, "Through research on (link here), I discovered that women who have miscarriages sometimes blame themselves for the event, wondering if every little event was the one that caused it. It can be psychologically devastating, and is hard to deal with without therapy".

Otherwise, good job!

P.S. I appreciate your sophisticated yet easy to read writing style.  

John:
Hey John,

I think that the first topic you'd like to explore further is a really interesting one (what are the reasons for marriage and birth to be so interconnected in our society?). Another thing that I liked was that in your response paragraph, you talked about society and then compared society's standards back to Tom and Jackie.

One thing I'd suggest is proofreading your work. There were a few minor grammar mistakes that you would have noticed i you'd combed through your work. Another benefit from proofreading is that you could probably see room for expansion and, by doing so, add some more "beauty" to your work.

Good Job! 

Comments on my Blog:
John:
Elizabeth!
Your interviews were interesting and you presented each one with something of a narrative arc, different from mine which is something i think i could work on. the details were the most nice spice, like how the doctor made threats and the nurse was incompetant. the one that struck me the most was the first interviewee only got offered a seat twice on the train in those 9 months, maybe my social obligations are more different than i thought than of others. im curious to know what neighborhood she would get off and on. another thing i also liked was how i could also very easily follow your thought process which almost made me feel im not alone at night looking at a computer reading someones blog. thanks for the stories,

John 

Lucas: 
Elizabeth,
Your interviews and their resulting analysis were very interesting to read; I found the part in which the doctor threatened your mother with a C-section particularly so, I wonder if doctors can legally perform such an operation under the given conditions (i.e. lack of consent). What do you think caused the 'superstitions' your grandmother had in relation to not buying baby items out of fear of essentially 'jinxing it'? Could it be a personal belief, or perhaps a cultural one?

I also kind of want to know the answer to the beer = milk question, it sounds worthy of investigation...

Nice post!

-Lucas  

Sara B (10th Grader @ different school):
Elizabeth -
I enjoyed very much reading what you wrote! It was interesting to read about different perspectives on pregnancy and birth stories, especially because the topic is so intimate and personal. I particularly was struck by when the first interviewee said she was only offered a seat on the subway twice throughout her whole pregnancy, despite riding it twice a day. You phrased it as this happened for 9 months, but women don't even start showing until later on in the pregnancy. Also, people can't always tell when someone's pregnant especially with coats on. Still, you'd think someone would notice, but maybe I just don't like the idea that our society is that inconsiderate. In terms of my own life, this post made me think about how I should find out about my own mother and grandmother's birth experience. You seem to have uncovered some funny details too, (like the myth beer = milk) and gained a better understanding of what it means to be pregnant. And of course it's interesting to think about what it means about society from way we treat pregnant people. Overall, I'm glad I read this post and heard all these interesting stories!

Sara B. :) 

 
Dad:
My reaction to your interviews, one of which was with me, is that I also found your grandmother’s comments most interesting. The most fascinating line was her comment about how drinking beer produces more breast milk. I had to laugh. I had never ever heard that before.

Given that your grandmother came from a different generation, it was interesting to see her perspective on pregnancy versus my point of view. I understood the superstitious aspect. I was surprised to learn that none of the pregnancies were planned. One thing that holds true even today is that people always want to touch the belly. To me it’s an invasion of one’s personal space. But people just seem to think it’s an accepted norm, as if they don’t even have to ask.

You indicate that it surprised you that I took such an interest in children, a notion I would guess that is normally associated with women. I think that comes from my father, who participated quite a lot in raising me, probably more than other fathers in the neighborhood. It was something I realized after I was well out of my teens; how lucky I had both a mother as well as a father who took an interest in my well being. I came to appreciate the experience I had with them. Some of my friends growing up were not as fortunate, coming from single parent homes and/or abusive environments. My parents set an example for me to follow. How well I carry on in the same tradition remains to be seen. As the saying goes, only time will tell.  

  

HW 36 - Pregnancy & Birth Stories

Interview 1
My first interview was with a woman who asked me to keep her identity private. I began by asking her how pregnancy effected her physically. She started by talking about the different stages of pregnancy. Her first trimester was easy, and the pregnancy only got difficult in the last three months. "Physically it wasn't that bad in the beginning, as the pregnancy progressed, the baby began to press on my internal organs...especially my bladder". Her changing body size presented a few minor challenges; "It was really hard to find sophisticated/work maternity clothing, my shoe size went up half a size, and I couldn't see my feet". Another obstacle her pregnancy brought was finding comfortable positions i.e. sleeping.

Then our conversation moved into the area of labor/giving birth. "Giving birth was not particularly pleasant...The waiting was bad". She went into labor on a Saturday night and didn't give birth until Sunday evening. I asked her how she had prepared for birth during her pregnancy. She had taken Lamaze classes with her husband. "All the training goes out the window when the baby actually comes...it was hard to focus on Lamaze breathing and exercises during the actual process of giving birth. I don't remember the pain but I remember that it was painful".

Next, we discussed other people's reactions to her pregnancy. "At work we didn't really discuss my pregnancy. I wanted to keep things professional; people think that become you're pregnant, you're less efficient at what you do. I worked up until the day before I went into labor". I asked her if strangers were interested in her pregnancy. She couldn't recall any encounters but she did remember that she was offered a seat on the subway twice in her 9 month pregnancy, during which she took the subway twice a day.  

"I remember thinking I was vaguely embarassed when I first started showing" She had gone through one unsuccessful pregnancy so she waited about three months before she told people she was pregnant. One thing that embarrassed her was that when she would tell someone "I'm pregnant", in her mind it would translate to "I had sex".
We also went over why she had a child. She said it was mainly because her husband so desperately wanted kids. But because of the pain, and the postpartum depression she developed after giving birth, she hasn't had any more children. 

Interview 2: Dad 

For this interview, I talked to my dad. I started by asking him simply how my mother's pregnancy effected him. He said that it could be unnerving at times to think about the pregnancy, "It kept me on my toes. I became very aware of being concerned about her welfare, because it wasn't just about her it was about you too". 

I asked him how he and my mom prepared for the birth. "We put together a bag that we could take out at the last minute, because we didn't know when labor could start. We thought through multiple plans of action because we were concerned about taking above ground transportation during winter". They also made a list of all of the people they wanted to call when my mom went into labor so they wouldn't forget anyone. He made sure he brought a camera because he wanted to take pictures, but my mom insisted that there not be a video camera because she didn't want the birth on tape.

I asked him to describe the hospital experience. "When we arrived, and were admitted to the room, there was a nurse that I can best describe as 'completely incompetent'. She couldn't set up an IV drip; she kept jabbing your mother without hitting the vein properly. I sought out the head nurse and screamed at her that 'my wife is not a pin cushion, I want someone to do the job, and do it right'. There was enough pain and she didn't need this nonsense". Apparently the doctor was "mean-spirted"; he essentially threatened my mom while she was giving birth, "He threatened to give her a C-section if she didn't push harder, which was the last thing she wanted. But i think he had to act that way to get your mother to not prolong the process". 

During our discussion he also said that "The funniest part of the birth was the fact that your mother, the NEW nurse, and I were all watching the marathon, and the runner took the wrong road to the finish line, so all three of us started screaming "go back go back go back" and then we all realized, "oh yeah, we're having a baby".

The part of the entire experience which stuck with him most was when the doctor pulled me out and held me upside down. He turned to hand me over to the nurse and in the process put my face inches from my dad's. "You were just screaming. Your face was purplish. I counted your fingers and toes to make sure you were all there. Then they placed you under a heating lamp and your skin started to look normal...The moment when you and I came face to face is something that will stick with me forever; it's exciting unique and one of a kind, and it's mine".  

The most difficult question for him to answer was the why. I asked him why he wanted to have children. "I think my reason is a many reason people have children, and this is selfish, but they want someone who is a part of them to carry on; someone who is a unique being; a product of two other beings. Kids are fun. Kids let us be kids again, through them". 


Interview 3: Grandma
My grandmother was still working as an assistant principal when she became pregnant with her first child. She told me that she "was not prepared for being nauseated", and that sometimes she would have to run back to her office and wait for a long time before she could get back to working. I asked her how she prepared for the birth, "I was superstitious about buying anything for the coming baby in case anything bad happened. The only thing I picked out was a crib, but my mother was going to buy it for us". But, she did get lucky in the supply department because the "godparents owned a baby clothing store and brought everything" when the baby was born.
Next, I asked her about how other people effected her pregnancy. "People always want to touch the belly, and there's really no way to stop them". She also said that she didnt know too much about nutrition because she was relatively thin at the time, and the only piece of "nutritional" advice she was given was that "after birth, drinking beer makes more milk for the baby". 
My final question was "Why did you decide to have children?". She said, "none of the babies were planned... there was no real concious decision". And actually when the third baby came along, she felt that she wasn't prepared, and was thinking about having an abortion. This was because the first two children were only twenty months apart and she felt that she couldn't handle a third child. "But my mother came to help, so it was okay". 

Overall Reflection
The first interview interested me because I thought it was peculiar that she was essentially ashamed of being pregnant at the beginning. I've always considered to be a positive experience in a woman's life. I think that maybe because she didn't necessarily have a want for children, pressure was added for her to live up to other people's standards. The second interview was interesting because I've always wondered what a man thinks about pregnancy. I thought it interesting that a man was more interested in having children than a woman. I think that because the woman had such high working standards, she didn't want a baby to interfere with work. This brought up a question for me, "are babies more important than working?". I thought about this because as organisms, our goal in life is essentially reproduce, isn't it? But, overall the most interesting conversation was with my grandma. I thought that the birth myth she talked about was really funny, and I thought it would be interesting to further explore and compare myths from now and "way back when".

After having these three  conversations, I would like to explore the "myths" behind birth and pregnancy. (i.e. beer=more breast-milk). 

*All people interviewed gave permission for their identities to be revealed except for interview 1

HW 35 - Other Peoples' Perspectives 1

For this assignment, I interviewed my friends Sophia, Braxton, Hayley and Praxitelies (Prax). With each conversation I started with the question, "Do you ever want to have children of your own?"

Sophia, 16, said that depending on her financial/work situation, she would probably have children in the future. Her biggest fear though was of the responsibility that comes with being a parent. We talked a bit about her personal life; when she was younger (and still now) she used to worry about her younger brother. She felt as though it was her responsibility to keep him safe from getting hurt etc.

Braxton, 16, began with an absolute yes. He even went on to say that he knew that he wanted two boys so that they "can play with each other and I can teach them the ways of the world". I asked him if there were any other reasons as to why he wanted boys, "I'm a guy... and I know teenage girls go through some insane stuff. Also, what if my daughter turned out to be a ho!?!?! nope. not dealing with it". He also said that were he to have children, he would undoubtedly want to be married to the female giving birth to his children. So I asked him what he would do should a female become impregnated by him and they weren't married. He simply said that it wouldn't happen, and that he would prevent pregnancy by using condoms. I asked him what other types of birth control were options, and he said, "lots of other types of condoms". However he is very aware that there are other types of birth control, because I asked him if it was wrong for women to use birth control drugs and he said "not at all".

The longest conversation I had was with my friend Prax, ~18. Similarly to Sophia, he said that he would probably want children in the future but that any final decision would depend on his career path. He also said that he would want to be married to a woman who was having his children. So I asked him, "If you were to impregnate a girl without being married, how do you think you would realistically handle the situation?". He replied, "Realistically i would discuss the possibility of abortion though ultimately the choice would be the woman's, and if she truly felt that she wanted to keep the child I would be obligated to provide". He went on to say that he is vehemently pro-choice but if presented with the option for another family to adopt, he would be fine with it. My final question to him was who/what he thought influenced his ideas/values around birth the most. He said, "my family".

My Conversation with Hayley, 16, helped me notice a pattern. Hayley said that she would most likely want one or two children in the future and that she thought that giving birth is painful. I asked her how she would know and she said that just the thought of a baby coming out of her own body sounds scary. Hayley's mom has told her on numerous occasions that the pain of pregnancy is worth the "joy of motherhood". During our conversation, Hayley referred to giving birth as "popping them out". I asked her why she said that. This is her reply, "Sometimes i feel that women, for whatever reason, want to have a ton of kids. It's certainly their choice, I just feel that women have been submissive to men for so long that it shouldn't ALL be about having kids and being a Mom anymore. Women should pursue whatever they want to pursue, and not have to feel tied down because of family. if they want to pursue family, so be it. but I think women should have a choice. And the popping them out part is I guess a biproduct of my resentment, or at least inability to relate to women who choose to build a family over pursuing a career." I really wanted to keep talking to her but our conversation got cut short. 

The pattern that Hayley helped me to see is that the females seemed to take this assignment more seriously than the males. There are certain things that Prax and Braxton said that showed that they weren't taking my questions seriously. Braxton had some jokey responses to some of my questions like "What kind of birth control would you use?" "glow in the dark condoms!!". Prax, would incorporate birth to becoming a world dictator, "were i to become a word dictator i would sire a small dynasty", "My other children have been strategically planted on all continents including Antarctica", "[Adoption] fits nicely into my whole continent theory
of world domination via pregnancy", "[Someone who influenced my ideals would be] Ghengis khan...he did so much raping and pillaging that something like 20% of asia can trace the population back to him". Overall I think that the answers weren't very deep thought-wise, but that it was more my fault as the interviewer for not asking more thought provoking questions.

HW 34 - Some Initial Thoughts On Birth

The first words that come to mind when I hear the word birth are pain & drugs. I picture a woman going into labor and she begs for an epidural, but they tell her it's too late and the baby is coming. This scene that just played in my head is probably way off of what it's really like. I don't have much experience with birth, other than being born. I really don't have any memories relating to "birth". All I can think of when I'm racking my brain are the women on trains and buses who are offered seats because they're pregnant. Yes, I've offered my seat on numerous occasions...it probably is a habit I picked up from my parents when I used to travel around the city with them. They would almost always get up for a pregnant woman and if they didn't, someone else already offered their seat, or they simply couldn't figure out if the woman was pregnant or overweight. 

I've watched part of the film The Business of Being Born. I fell asleep part way through, but I watched enough to get a general idea of what the filmmakers were trying to say. They basically challenge hospital birth with the growing number of women who are choosing to give home-births. They point out that home-birth is cheaper and can be less dangerous than hospital birth. But I still wonder which is better. 

Questions I still have:

- When did birth get a price tag put on it? (How did the "industry" around hospital birth come around?)

- Are all women presented with options relating to the birth of their child when they become pregnant? 

- What validates someone as a good potential mother? (Are children given unfair beginnings   because of the choices their parents make?)